Reading man flap for repair of soft tissue defects in distal fingers

Objective To explore the Reading man flap for the treatment of soft tissue defects in distal fingers. Methods From May, 2014 to June, 2017, Reading man flaps were transferred in the emergency room to repair soft tissue defects in distal fingers in 46 patients. There were 28 cases of finger pulp defects, 6 cases of dorsal defects and 12 cases of finger stump defects with the size of soft tissue defects ranged from 1.0 cm×0.9 cm to 2.2 cm×2.0 cm (average, 1.2 cm×1.3 cm). The volar, dorsal and hybrid flaps were 28, 6 and 12 cases respectively. The average size of the major flap and minor flap were 1.8 cm×1.2 cm and 1.4 cm×0.8 cm, respectively. All donor sites were sutured directly. All patients were followed-up by review in the outpatient department. Results The consumed operative time was 35-48 min, with an average of 37.8 min. Prophylactic antibiotics and wound dressing were conducted postoperatively. The tip of the minor flaps occurred inflammation and small blister in 2 cases and eased by removal of the tip sutures. Traumatic neuralgia occurred in 1 case and self-healed after 3 months. Twenty-six cases were followed-up at least 11 months, which were 16 cases of finger pulp defects, 3 of dorsal defects and 7 of finger stump defects. On an average of 10.5 (9-27) months followed-up, all flaps survived. Except 4 cases with slim hook nail deformity, the remaining flaps were observed with satisfactory texture and appearance, the bulky deformity and scar contracture did not occur. Two points distinguishment on the major and minor flaps were 3.3-6.2 (average, 4.5) mm and 5.5-9.8 (average, 7.1) mm respectively. According to the Trial Standard for Evaluation of Upper Limb Function of Chinese Society of Hand Surgery, it was excellent in 28 cases, good in 11 cases and moderate in 7 cases, with the overall excellent and good rate of 84.8%. Conclusion The Reading man flap is a good option for treatment of the small size soft tissu defect in distal fingers with the advantages of simple procedure, high success rate, good appearance and sensory recovery. Key words: Reading man flap; Surgical flap; Soft tissue defect; Finger; Repair